Senate Bill sb1408e1

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    SB 1408                                        First Engrossed



  1                      A bill to be entitled

  2         An act relating to medical records; amending s.

  3         456.057, F.S.; providing definitions; requiring

  4         a health care practitioner's employer who is a

  5         records owner and a records custodian to comply

  6         with specified requirements for confidentiality

  7         and disclosure; amending s. 456.42, F.S.;

  8         providing requirements for prescriptions of

  9         medicinal drugs by health care practitioners

10         which are electronically generated or

11         transmitted; creating s. 456.43, F.S.;

12         regulating electronic prescribing for medicinal

13         drugs; providing restrictions for electronic

14         prescribing software; providing definitions;

15         authorizing electronic prescribing software to

16         show information regarding a payor's formulary

17         under certain circumstances; amending s.

18         465.025, F.S.; specifying requirements for a

19         prescriber to prevent generic substitution of

20         brand name drugs when a prescription is

21         electronically transmitted or generated;

22         amending s. 381.028, F.S.; conforming a

23         cross-reference; providing an effective date.

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25  Be It Enacted by the Legislature of the State of Florida:

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27         Section 1.  Present subsections (3) through (19) of

28  section 456.057, Florida Statutes, are redesignated as

29  subsections (5) through (21), respectively, and new

30  subsections (3) and (4) are added to that section, to read:

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    SB 1408                                        First Engrossed



 1         456.057  Ownership and control of patient records;

 2  report or copies of records to be furnished.--

 3         (3)  As used in this section, the term "records

 4  custodian" means any person or entity that:

 5         (a)  Maintains documents that are authorized in

 6  subsection (2); or

 7         (b)  Obtains medical records from a records owner.

 8         (4)  Any health care practitioner's employer who is a

 9  records owner and any records custodian shall maintain records

10  or documents as provided under the confidentiality and

11  disclosure requirements of this section.

12         Section 2.  Section 456.42, Florida Statutes, is

13  amended to read:

14         456.42  Written prescriptions for medicinal drugs.--A

15  written prescription for a medicinal drug issued by a health

16  care practitioner licensed by law to prescribe such drug must

17  be legibly printed or typed so as to be capable of being

18  understood by the pharmacist filling the prescription; must

19  contain the name of the prescribing practitioner, the name and

20  strength of the drug prescribed, the quantity of the drug

21  prescribed in both textual and numerical formats, and the

22  directions for use of the drug; must be dated with the month

23  written out in textual letters; and must be signed by the

24  prescribing practitioner on the day when issued. However, a

25  prescription that is electronically generated and transmitted

26  must contain the name of the prescribing practitioner, the

27  name and strength of the drug prescribed, the quantity of the

28  drug prescribed in numerical format, and the direction for use

29  of the drug and must be dated and signed by the prescribing

30  practitioner only on the day issued, which signature may be in

31  an electronic format as defined in s. 668.003(4).


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    SB 1408                                        First Engrossed



 1         Section 3.  Section 456.43, Florida Statutes, is

 2  created to read:

 3         456.43  Electronic prescribing for medicinal drugs.--

 4         (1)  Electronic prescribing shall not interfere with a

 5  patient's freedom to choose a pharmacy.

 6         (2)  Electronic prescribing software shall not use any

 7  means or permit any other person to use any means, including,

 8  but not limited to, advertising, instant messaging, and pop-up

 9  ads, to influence or attempt to influence, through economic

10  incentives or otherwise, the prescribing decision of a

11  prescribing practitioner at the point of care. Such means

12  shall not be triggered or in specific response to the input,

13  selection, or act of a prescribing practitioner or his or her

14  agent in prescribing a certain pharmaceutical or directing a

15  patient to a certain pharmacy.

16         (a)  The term "prescribing decision" means a

17  prescribing practitioner's decision to prescribe a certain

18  pharmaceutical or direct a patient to a certain pharmacy.

19         (b)  The term "point of care" means the time that a

20  prescribing practitioner or his or her agent is in the act of

21  prescribing a certain pharmaceutical or directing a patient to

22  a certain pharmacy.

23         (3)  Electronic prescribing software may show

24  information regarding a payor's formulary as long as nothing

25  is designed to preclude or make more difficult the act of a

26  prescribing practitioner or patient selecting any particular

27  pharmacy or pharmaceutical.

28         Section 4.  Subsection (2) of section 465.025, Florida

29  Statutes, is amended to read:

30         465.025  Substitution of drugs.--

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    SB 1408                                        First Engrossed



 1         (2)  A pharmacist who receives a prescription for a

 2  brand name drug shall, unless requested otherwise by the

 3  purchaser, substitute a less expensive, generically equivalent

 4  drug product that is:

 5         (a)  Distributed by a business entity doing business,

 6  and subject to suit and service of legal process, in the

 7  United States; and

 8         (b)  Listed in the formulary of generic and brand name

 9  drug products as provided in subsection (5) for the brand name

10  drug prescribed,

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12  unless the prescriber writes the words "MEDICALLY NECESSARY,"

13  in her or his own handwriting, on the face of a written

14  prescription; or unless, in the case of an oral prescription,

15  the prescriber expressly indicates to the pharmacist that the

16  brand name drug prescribed is medically necessary; or unless,

17  in the case of a prescription that is electronically generated

18  and transmitted, the prescriber makes an overt act when

19  transmitting the prescription to indicate that the brand name

20  drug prescribed is medically necessary. When done in

21  conjunction with the electronic transmission of the

22  prescription, the prescriber's overt act indicates to the

23  pharmacist that the brand name drug prescribed is medically

24  necessary.

25         Section 5.  Paragraph (c) of subsection (7) of section

26  381.028, Florida Statutes, is amended to read:

27         381.028  Adverse medical incidents.--

28         (7)  PRODUCTION OF RECORDS.--

29         (c)1.  Fees charged by a health care facility for

30  copies of records requested by a patient under s. 25, Art. X

31  of the State Constitution may not exceed the reasonable and


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    SB 1408                                        First Engrossed



 1  actual cost of complying with the request, including a

 2  reasonable charge for the staff time necessary to search for

 3  records and prevent the disclosure of the identity of any

 4  patient involved in the adverse medical incident through

 5  redaction or other means as required by the Health Insurance

 6  Portability and Accountability Act of 1996 or its implementing

 7  regulations. The health care facility may require payment, in

 8  full or in part, before acting on the records request.

 9         2.  Fees charged by a health care provider for copies

10  of records requested by a patient under s. 25, Art. X of the

11  State Constitution may not exceed the amount established under

12  s. 456.057(18) s. 456.057(16), which may include a reasonable

13  charge for the staff time necessary to prevent the disclosure

14  of the identity of any patient involved in the adverse medical

15  incident through redaction or other means as required by the

16  Health Insurance Portability and Accountability Act of 1996 or

17  its implementing regulations. The health care provider may

18  require payment, in full or in part, before acting on the

19  records request.

20         Section 6.  This act shall take effect July 1, 2006.

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